Chronic spontaneous urticaria has major detrimental effects on quality of life, with sleep deprivation and psychiatric comorbidity being frequent. It also has a large impact on society in terms of direct and indirect health care costs as well as reduced performance at work and in private life.

Causal and/or curative treatment is difficult

In the majority of patients, an underlying cause cannot be identified making a causal and/or curative treatment difficult.

Nonsedating H(1) -antihistamines are the mainstay of symptomatic therapy, but treatment with licensed doses relieves symptoms effectively in less than 50% of patients.

Although guideline-recommended up-dosing up to 4-fold increases symptom control in many patients, a substantial number of patients have only little benefit from H(1) -antihistamines.

Consequently, there is a great need for new therapeutic strategies. Omalizumab showed a benefit in a short-term study reported at the 2010 ACAAI Annual Meeting.

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